LYDIA JEANNETTE HENDERSON

CHICAGO, IL
NPI1942835053
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: IL  125.081124)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-03-09
Last Update Date2023-09-15
Business Address
LYDIA JEANNETTE HENDERSON
251 E HURON ST
CHICAGO, IL 60611-2908
Phone number: 510-909-0621
Mailing Address
LYDIA JEANNETTE HENDERSON
5314 CROWN CT
CASTRO VALLEY, CA 94552-2616
Phone number: 510-909-0621